|Publication number||US7608075 B2|
|Application number||US 11/340,615|
|Publication date||Oct 27, 2009|
|Filing date||Jan 27, 2006|
|Priority date||Feb 1, 2005|
|Also published as||DE602006001114D1, EP1685803A1, EP1685803B1, US20060173457|
|Publication number||11340615, 340615, US 7608075 B2, US 7608075B2, US-B2-7608075, US7608075 B2, US7608075B2|
|Original Assignee||Tornier Sas|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (82), Non-Patent Citations (4), Referenced by (16), Classifications (8), Legal Events (5)|
|External Links: USPTO, USPTO Assignment, Espacenet|
This invention relates to a humeral nail.
When a fracture occurs, the proximal part of the humerus can break into several pieces. It is known that these different fragments can be brought together using a humeral nail like that according to the invention.
A nail of this type, for example like that disclosed in U.S. Pat. No. 5,472,444, includes an elongated body that is inserted in the medullary canal of the humerus. This body is hollowed out with various drillings through which screws can pass to mutually interlock the nail and the humeral shaft.
This body is terminated by a proximal end in which at least three orifices are formed, offset at angles from each other. These different orifices house corresponding screws that interlock the different bone fragments that were initially split.
However, this known solution has some disadvantages. Interlocking screws for bone segments tend to become unscrewed, such that their position is modified after implantation, which can cause pain for the patient. Furthermore, if this unscrewing takes place shortly after the surgical operation, consolidation of the humerus assembly may be completely deficient.
To overcome this disadvantage, WO-A-2004/100810 proposes a humeral nail with a main body, different interlocking screws and an internal sheath capable of sliding within the volume inside the body. This sheath has various orifices formed in it, through which the above-mentioned screws can pass.
The first step in placing the nail is to place the sheath inside the body of the nail, and then penetrate the screws through the various orifices formed in the body and in the sheath, respectively. The sheath is then moved along the main axis of the body so as to interlock the screws using the walls of the orifices in the sheath, which stop in contact with the surfaces facing the screws.
However, this alternate solution has disadvantages. In particular, the reliability of the attachment of the nail in the humerus is not always satisfactory.
Having said this, the invention is aimed at proposing a humeral nail capable of overcoming these various disadvantages.
Consequently, the present invention is a humeral nail including an elongated body that can be at least partially inserted into the medullary canal of the humerus, the body including a proximal part with housing orifices into which interlocking devices, such as screws, are inserted to interlock the initially split humeral fragments, the nail also includes a locking device capable of locking the interlocking devices, the locking device being free to move relative to the body between a position in which the interlocking devices are free to move, in which the locking device enables free passage of the interlocking means through the orifices, and a locking position of the interlocking devices in which the locking device locks the interlocking devices relative to the walls of the orifices, characterised in that the locking device includes several openings, each of which includes a free passage part extending in front of a corresponding orifice in the free passage position, and a locking part, the walls of which stop in contact with a corresponding interlocking device, in the locking position.
The invention will be better understood and other advantages will become more clear after reading the following description of an embodiment of a humeral nail according to its principle, given simply as a non-limitative example with reference to the attached drawings in which:
As shown particularly in
The body 4 is provided with a proximal part 4 3 opposite the tip 4 1 which is cylindrical in shape and has a circular cross-section. The proximal part is hollowed out with three through orifices 4 4 that are circular in shape, and are arranged vertically in line with each other. The orifices 4 4 may advantageously be offset at angles from each other in pairs according to the information given in U.S. Pat. No. 5,472,444.
The humeral nail 2 also includes a sheath 6 open at both its ends that is visible particularly in
Three through openings 6 1 pass through the sheath 6, the locations of which correspond approximately to the locations of the orifices 4 4. As shown more precisely in
As shown particularly in
Furthermore, the body 4 is provided with a stud 4 5 with a substantially circular section with through dimensions globally corresponding to the dimensions of the housings 6 21 and 6 22. As will be seen in the following, the stud 4 5 can fit selectively into either of the two housings 6 21 and 6 22.
Finally, the humeral nail 2 according to the invention comprises a hollow cylindrically-shaped cap 8 with the same diameter as the sheath 6. This cap 8 can be blocked as will be seen in the following, using a screw 10.
Placement of the nail 2 in the humerus 100 described above will now be explained in the following.
One objective is to add the sheath 6 around the proximal part 4 3 so that the orifices 4 4 coincide with the circular parts 6 11 of the openings 6 1. The assembly formed from the body 4 and the sheath 6 is then inserted into the medullary canal 108 of the humerus 100. As a variant, the body 4 can be inserted into the medullary canal 108 first, and the sheath 6 can then be added around the proximal part 4 3. Furthermore, the stud 4 5 of the body 4 fits into the lower housing 6 22 of the notch 6 2 formed in the sheath 6, which corresponds to the layout in
Under these conditions, it is possible to pass interlocking screws 22 through the orifices 4 4, the interlocking screws 22 being visible particularly in
The sheath 6 is made to slide relative to the body 4 for example either manually or using an appropriate tool. In the example considered, the objective is to push the sheath 6 towards the distal part 4 1 of the body 4, using the cap 8 and the screw 10.
More precisely, the cap 8 is added around the proximal part 4 3 of the body 4, the screw 10 is inserted in the inner volume of the cap 8, and the screw 10 is then made to cooperate with an inner thread (not shown) formed in the proximal part 4 3 of the body 4. This screwing of the screw 10 contributes to moving the cap 8 and consequently the sheath 6 along the main axis of the body 4, which is materialised by the arrow F in
Therefore, it can be seen that the head 10 1 of the screw 10 forms a stop for the cap 8 such that the cap 8 is immobilised axially relative to the body 4. Consequently, the cap 8 also contributes to axially locking the sheath 6 with respect to the body 4.
When the displacement mentioned above regarding the sheath 6 and the body 4 is terminated, the circular parts 6 11 are no longer coincident with the orifices 4 4, and the walls of the slots 6 12 are then in contact with the surfaces facing the screws 22. The walls of the slots 6 12 then act as a stop for the screws 22 and prevent any movement of the screws 22, particularly an unscrewing movement. The circular parts 6 11 thus form free passage parts for the screws 22, while the slots 6 12 form parts locking the screws 22.
It should be noted that the through dimensions of the circular parts 6 11 are larger than the dimensions of the screws 22, such that the screws can slide freely. On the other hand, the through dimensions of the slots 6 12 decrease towards the closed end of each slot. Consequently, when the sheath moves, the walls of these slots 6 12 cap the surfaces facing the screws 22 so as to lock them and keep them in position.
Furthermore, sliding of the sheath 6 with respect to the body 4 causes displacement of the stud 4 5 from the lower housing 6 22 towards the upper housing 6 21, which corresponds to the position in
It can be imagined that in the position shown in
The invention is not limited to the example described and shown.
The sheath 6 extending outside the body 4 can be replaced by a locking device installed free to slide inside the hollow body. The locking device has a smaller diameter and is also provided with openings through which the interlocking screws 22 can be selectively locked.
Furthermore, the slots can extend in different directions from the direction shown. Thus, they can extend the circular parts downwards, obliquely or laterally.
Furthermore, several types of sheaths can be used, the openings of which have different spacings and/or orientations. The most suitable sheath can be chosen for this purpose as a function of the configuration of the bone fragments to be brought together.
Finally, more than one locking notch can be provided to lock the sheath 6 with respect to the body 4, such as 6 2 described with reference to
The invention provides a means of achieving the objective mentioned above.
The Applicant realised that the solution described in WO-A-2004/100810 is not very satisfactory, because it does not assure that the interlocking screws are reliably held in position. Thus, these screws are locked by the walls of circular orifices, which necessarily have a larger cross section than the screws since the screws need to slide through these orifices in the free passage position. Under these conditions, the locking force generated by the walls of these orifices is relatively low, such that the screws tend to move away from their initial position.
On the other hand, according to the invention, the sheath 6 reliably locks the interlocking screws 22 which prevents any accidental unscrewing. In this respect, it should be noted that the free passage part of each opening that has large dimensions enables easy sliding of the screws. Furthermore, the different locking parts that are smaller in dimension reliably hold these screws in position.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US4622959 *||Mar 5, 1985||Nov 18, 1986||Marcus Randall E||Multi-use femoral intramedullary nail|
|US5122141 *||Aug 30, 1990||Jun 16, 1992||Zimmer, Inc.||Modular intramedullary nail|
|US5171289||Nov 18, 1991||Dec 15, 1992||Etablissements Tornier||Femoral prosthesis with cement retaining seal|
|US5314485||Sep 11, 1992||May 24, 1994||Etablissements Tornier||Total prosthesis of the wrist|
|US5326359||Nov 24, 1992||Jul 5, 1994||Etablissements Tornier||Knee prosthesis with adjustable centro-medullary stem|
|US5358526||Nov 10, 1992||Oct 25, 1994||Etablissements Tornier||Modular shoulder prosthesis|
|US5405399||May 11, 1993||Apr 11, 1995||Etablissements Tornier||Total prosthesis for the metacarpo-phalangeal joint|
|US5429639||May 9, 1994||Jul 4, 1995||Tornier S.A.||Spine fixator for holding a vertebral column|
|US5458650||Mar 8, 1994||Oct 17, 1995||Tornier S.A.||Elastically deformable cotyloidal prosthesis|
|US5472444||May 13, 1994||Dec 5, 1995||Acumed, Inc.||Humeral nail for fixation of proximal humeral fractures|
|US5505731||Aug 26, 1994||Apr 9, 1996||Tornier Sa||Screw for lumbar-sacral fixator|
|US5505734 *||Oct 5, 1994||Apr 9, 1996||Gruppo Industriale Bioimpianti S.R.L.||Lockable intramedullary nail for the humerus|
|US5562667 *||Apr 25, 1995||Oct 8, 1996||Shuler; Thomas E.||Intramedullary rod for fracture fixation of femoral shaft independent of ipsilateral femoral neck fracture fixation|
|US5591168||May 7, 1996||Jan 7, 1997||Tornier S.A.||Device for stabilizing fractures of the upper end of the femur|
|US5653709||Nov 3, 1994||Aug 5, 1997||Synthes (U.S.A.)||Modular marrow nail|
|US5658287 *||Jun 3, 1996||Aug 19, 1997||Gruppo Industriale Bioimpianti S.R.L.||Locked intramedullary nail, suitable in particular for fractures of the femur|
|US5662651||Sep 5, 1995||Sep 2, 1997||Tornier S.A.||External or internal fixator for repairing fractures or arthroplasties of the skeleton|
|US5676702||Dec 1, 1995||Oct 14, 1997||Tornier S.A.||Elastic disc prosthesis|
|US5702447||Nov 27, 1996||Dec 30, 1997||Tornier S.A.||Device for the attachment of a glenoid prosthesis of the shoulder blade|
|US5702457||Nov 14, 1995||Dec 30, 1997||Tornier Sa||Humeral prosthesis incorporating a sphere|
|US5702478||Jun 7, 1996||Dec 30, 1997||Tornier Sa||Acetabular implant intended in particular for the iliac joint socket|
|US5704939 *||Apr 9, 1996||Jan 6, 1998||Justin; Daniel F.||Intramedullary skeletal distractor and method|
|US5766256||Jan 22, 1997||Jun 16, 1998||Tornier Sa||Tibial prosthesis|
|US5824106||Apr 9, 1997||Oct 20, 1998||Tornier Sa||Ankle prosthesis|
|US5879395||Jan 21, 1998||Mar 9, 1999||Tornier Sa||Total elbow prosthesis|
|US5928235 *||Nov 7, 1997||Jul 27, 1999||Endocare Ag||Osteosynthesis auxiliary for the treatment of subtrochanteric, peritrochanteric, and femoral-neck fractures|
|US6120504 *||Dec 10, 1998||Sep 19, 2000||Biomet Inc.||Intramedullary nail having dual distal bore formation|
|US6162254||Oct 14, 1998||Dec 19, 2000||Tornier S.A.||Knee prosthesis|
|US6165224||Oct 1, 1998||Dec 26, 2000||Tornier Sa||Prosthesis intended to be anchored in a long bone|
|US6168595 *||Dec 20, 1999||Jan 2, 2001||Orthomatrix, Inc.||Modular intramedullary fixation system and insertion instrumentation|
|US6168629||Oct 14, 1998||Jan 2, 2001||Tornier S.A.||Femoral component for knee prosthesis|
|US6171341||Jul 28, 1997||Jan 9, 2001||Tornier Sa||Prosthesis for the upper extremity of the humerus|
|US6183519||Mar 9, 1998||Feb 6, 2001||Tornier Sa||Ankle prosthesis|
|US6206925||Sep 11, 1998||Mar 27, 2001||Tornier Sa||Elbow prosthesis with indexed sphere|
|US6228086 *||Mar 19, 1998||May 8, 2001||Stryker Trauma-Selzach Ag||Modular intramedullary nail|
|US6299646||Sep 23, 1998||Oct 9, 2001||Tornier Sa||Knee prosthesis with a rotational plate|
|US6328758||Apr 21, 1999||Dec 11, 2001||Tornier Sa||Suture anchor with reversible expansion|
|US6334874||Jun 9, 2000||Jan 1, 2002||Tornier Sa||Humeral prosthesis|
|US6379387||May 10, 2000||Apr 30, 2002||Tornier Sa||Elbow prosthesis|
|US6402753 *||Jul 19, 2000||Jun 11, 2002||Orthodyne, Inc.||Femoral intramedullary rod system|
|US6454809||Mar 2, 1999||Sep 24, 2002||Tornier Sa||Modular acetabular or cotyloid implant|
|US6488712||Aug 3, 2000||Dec 3, 2002||Tornier Sa||Malleolar implant for partial or total ankle prosthesis|
|US6540770||Apr 21, 1999||Apr 1, 2003||Tornier Sa||Reversible fixation device for securing an implant in bone|
|US6582469||Dec 11, 1998||Jun 24, 2003||Tornier S.A.||Knee prosthesis|
|US6599295||Apr 21, 1999||Jul 29, 2003||Tornier Sa||Device for setting and removing an implant such as a suture anchor|
|US6626946||Jul 29, 1999||Sep 30, 2003||Tornier Sa||Shoulder prosthesis and humeral stems for such a prosthesis|
|US6761740||Feb 12, 2003||Jul 13, 2004||Tornier||Glenoid component of a shoulder prosthesis and complete shoulder prosthesis incorporating such a component|
|US6767368||Apr 29, 2002||Jul 27, 2004||Tornier Sa||Elbow prosthesis|
|US6802864||Oct 29, 2002||Oct 12, 2004||Toriner Sa||Patellar implant and knee prosthesis incorporating such an implant|
|US6824567||Sep 26, 2002||Nov 30, 2004||Tornier||Method of positioning a malleolar implant for partial or total ankle prosthesis|
|US6890357||May 21, 2004||May 10, 2005||Tornier||Elbow prosthesis|
|US6921400 *||May 30, 2003||Jul 26, 2005||Gary W. Sohngen||Modular intramedullary nail|
|US6926719 *||Jun 13, 2002||Aug 9, 2005||Gary W. Sohngen||Modular intramedullary nail|
|US6932819 *||Jan 30, 2003||Aug 23, 2005||Stryker Trauma Sa||Modular intramedullary nail|
|US6969406||Feb 4, 2003||Nov 29, 2005||Tornier Sa||Prosthetic element comprising two components and process for assembling such a prosthetic element|
|US7018380||Dec 21, 2001||Mar 28, 2006||Cole J Dean||Femoral intramedullary rod system|
|US7033396||Jul 3, 2003||Apr 25, 2006||Tornier||Shoulder or hip prosthesis facilitating abduction|
|US7232442 *||Feb 22, 2005||Jun 19, 2007||Advanced Orthopaedic Solutions||Humeral nail|
|US7297163 *||Dec 16, 2002||Nov 20, 2007||Acumed Llc||Shoulder prosthesis|
|US20030009170||Jul 8, 2002||Jan 9, 2003||Alain Tornier||Ancillary tool for fitting an ulnar component and/or a radial component of an elbow prosthesis|
|US20030009171||Jul 8, 2002||Jan 9, 2003||Alain Tornier||Ancillary tool for fitting a humeral component of an elbow prosthesis|
|US20030028198||Sep 26, 2002||Feb 6, 2003||Alain Tornier||Tool for placing a malleolar implant for partial or total ankle prosthesis|
|US20040134821||Dec 9, 2003||Jul 15, 2004||Alain Tornier||Process for the sterile packaging of a prosthetic implant made of polyethylene|
|US20040210220||Jul 17, 2002||Oct 21, 2004||Alain Tornier||Osteosynthesis plate for the upper end of the arm bone|
|US20040215200||Jan 16, 2004||Oct 28, 2004||Alain Tornier||Ancillary tool and method for positioning a prosthetic acetabulum of a hip prosthesis|
|US20040230197||Mar 8, 2004||Nov 18, 2004||Alain Tornier||Ancillary tool for positioning a glenoid implant|
|US20050049709||Aug 25, 2004||Mar 3, 2005||Alain Tornier||Glenoid component of a shoulder prosthesis and complete shoulder prosthesis incorporating such a component|
|US20050055102||May 11, 2004||Mar 10, 2005||Alain Tornier||Set of prosthetic elements for a tibial prosthetic assembly|
|US20050165490||Dec 15, 2004||Jul 28, 2005||Alain Tornier||Shoulder or hip prosthesis and process for fitting same|
|US20050203536||Feb 10, 2005||Sep 15, 2005||Philippe Laffargue||Surgical device for implanting a total hip prosthesis|
|US20050278030||Jun 8, 2005||Dec 15, 2005||Tornier||Glenoidal component, set of such components and shoulder prosthesis incorporating such a glenoidal component|
|US20050278031||Jun 9, 2005||Dec 15, 2005||Tomier||Set of humeral components for total shoulder prosthesis|
|US20050278032||Jun 14, 2005||Dec 15, 2005||Tornier||Glenoidal component of a shoulder prosthesis, set of elements constituting such a component and total shoulder prosthesis incorporating such a component|
|US20050278033||Jun 14, 2005||Dec 15, 2005||Alain Tornier||Total shoulder prosthesis or inverted type|
|US20050288791||Jun 24, 2005||Dec 29, 2005||Tornier||Shoulder or hip prosthesis|
|US20060015185||Jun 3, 2005||Jan 19, 2006||Pierre Chambat||Knee prosthesis with a rotational plate|
|US20060064096 *||Sep 12, 2005||Mar 23, 2006||Stryker Trauma Gmbh||Intermedullary locking nail|
|US20060095039 *||Jan 20, 2004||May 4, 2006||Mutchler Austin W||Intramedullary nail and associated method|
|US20060235538||Apr 11, 2006||Oct 19, 2006||Tornier||Surgical apparatus for implantation of a partial of total knee prosthesis|
|US20070100343 *||May 17, 2004||May 3, 2007||Cole Dean J||Intramedullary nail assembly|
|JP2000051225A||Title not available|
|WO2004100810A1||May 17, 2004||Nov 25, 2004||Depuy International Limited||An intramedullary nail assembly|
|1||Ratron et al., U.S. Appl. No. 11/626,735, entitled "Surgical Instrumentation Kit for Inserting an Ankle Prothesis," filed Jan. 24, 2007.|
|2||Rochetin et al., U.S. Appl. No. 11/401,415, entitled "Surgical Apparatus for Implantation of a Partial or Total," filed Apr. 11, 2006.|
|3||Rochetin, U.S. Appl. No. 11/194,452, entitled "Patellar Retractor and Method of Surgical Procedure on Knee," filed Aug. 2, 2005.|
|4||Rochetin, U.S. Appl. No. 11/670,274, entitled "Offset Stem Tibial Implantation," filed Feb. 1, 2007.|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US7763023||Jul 27, 2010||Yechiel Gotfried||Intramedullary nail system and method for fixation of a fractured bone|
|US8137348||Oct 31, 2007||Mar 20, 2012||Yechiel Gotfried||Apparatus for treating a fractured bone|
|US8435238 *||May 7, 2013||Michigan State University||Devices and methods for interlocking surgical screws and nails|
|US8460294||May 2, 2011||Jun 11, 2013||DePuy Synthes Products, LLC||Intramedullary nail|
|US8939978||Mar 31, 2011||Jan 27, 2015||Smith & Nephew, Inc.||Orthopaedic plate and screw assembly|
|US9072553 *||Mar 26, 2013||Jul 7, 2015||The Board Of Trustees Of Michigan State University||Devices and methods for interlocking surgical screws and nails|
|US9161796||Dec 17, 2011||Oct 20, 2015||The Brigham And Women's Hospital, Inc.||Medical devices for use during ankle fusion surgery|
|US20060084997 *||Oct 5, 2005||Apr 20, 2006||Michigan State University, A Michigan Corporation||Devices and methods for interlocking surgical screws and nails|
|US20080058813 *||Oct 31, 2007||Mar 6, 2008||Yechiel Gotfried||Apparatus and method fixing a fractured bone|
|US20080058814 *||Oct 31, 2007||Mar 6, 2008||Yechiel Gotfried||Apparatus for treating a fractured bone|
|US20080119856 *||Nov 20, 2006||May 22, 2008||Yechiel Gotfried||Intramedullary nail system and method for fixation of a fractured bone|
|US20080195098 *||Feb 9, 2007||Aug 14, 2008||Yechiel Gotfried||Intramedullary nail system and method for fixation of a fractured bone|
|US20110046625 *||May 6, 2009||Feb 24, 2011||Tornier||Surgical technique and apparatus for proximal humeral fracture repair|
|US20120265202 *||Oct 12, 2010||Oct 18, 2012||Zimmer Gmbh||Orthopedic nail and an orthopedic nail system|
|US20140243827 *||May 5, 2014||Aug 28, 2014||Tornier||Surgical technique and apparatus for proximal humeral fracture repair|
|US20140309637 *||Mar 26, 2013||Oct 16, 2014||Board Of Trustees Of Michigan State University||Devices and methods for interlocking surgical screws and nails|
|Cooperative Classification||A61B17/744, A61B17/7241, A61B17/72|
|European Classification||A61B17/74D2, A61B17/72E2, A61B17/72|
|Jan 27, 2006||AS||Assignment|
Owner name: TORNIER, FRANCE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:TORNIER, ALAIN;REEL/FRAME:017515/0640
Effective date: 20051220
|May 20, 2008||AS||Assignment|
Owner name: TORNIER SAS, FRANCE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:TORNIER;REEL/FRAME:020963/0681
Effective date: 20080417
Owner name: TORNIER SAS,FRANCE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:TORNIER;REEL/FRAME:020963/0681
Effective date: 20080417
|Jun 7, 2013||REMI||Maintenance fee reminder mailed|
|Oct 27, 2013||LAPS||Lapse for failure to pay maintenance fees|
|Dec 17, 2013||FP||Expired due to failure to pay maintenance fee|
Effective date: 20131027